Whoa - didn't realize it until today but it's nearly been 2 months since I posted. My sister called me out. Told me that I was still stuck in surgery in blogland. I decided that must be remedied immediately!!! So here's a quick rundown of what's been going on lately.
Finished surgery, took the test, class average was a 67 - most definitely the lowest our class average has ever been on any test. Very surprising to me.
Started and finished my family medicine rotation. We do 2 weeks at a big hospital with the family medicine residents and attendings. Then we go off to a "rural" location. Most everyone picks their hometown since they have a free place to stay. I did this and the funniest part to me was that 1/2 way through my 4 weeks, one of my relatives (not telling which one, wouldn't want to have a HIPPA violation!) ended up becoming an inpatient. Not just any inpatient, but a patient on my attending's service. That means I had to go see them every morning and afternoon, get the pertinent info, write the note, etc... It was pretty funny. Here's the breakdown of hours for each part for those of you who want to know what you have to look forward to :)
Big Teaching Hospital: arrive around 6 or 6:30. See 2 patients (no matter how many are on the service, which is AWESOME). Write notes. Go to morning conference at 8. Usually a specialist of some sort would come in and teach for 15 minutes. Then we'd head down to the doctor's lounge and run the list/dry round over delicious breakfast. FREE delicious breakfast. They really know how to treat students and docs over there! Then we'd go on work rounds. Then we'd have class. Then free lunch. Then class. Then home by 3ish. It was pretty relaxed.
"Rural" Medicine: Get to hospital between 6 and 7 depending on how many inpatients we had. My preceptor and I would split up the patients or "divide and conquer" as he liked to say. I'd usually see 2 or 3, write their notes, then he'd look it over and tell me what orders to write. Then he'd sign them. I really enjoyed getting to know the entire staff at the hospital there. It's so different from being at a big teaching hospital where noone really knows each other. Anyway, then we'd go to clinic and see about 15-25 patients from 8:00-4:30 or 5:00. Then it was time to head back to the hospital for afternoon rounds. I usually got home around 6. All in all not a bad experience, but I'm not sure it's for me. Think I would approach burnout very quickly. Not so much from the hours worked, but from the patient population. That's a long story for another day though. Let's just say I'll be okay if I never have to hear about low back pain EVER, EVER again... My preceptor was incredibly nice, liked to quiz, liked to teach, and trusted my work which was exciting and scary all at once. I did most of the admitting H&Ps on new patients coming in and a few of his discharge summaries. He'd usually sign orders before I wrote them after going through a care plan with me. Very strange to write orders and have nurses ask you, seriously, what tests you wanted done, IV fluids, etc...
Now for a fun update - this past weekend the stars and planets must have aligned just right because for once:
1) I had no responsibilities, technically (I guess I could have been studying for well, anything)
2) My husband was able to take off Friday, Saturday, AND Sunday
3) His grandparents just so happened to have rented out a 3 bedroom suite overlooking the Gulf Coast.
Fun times ensued. K's grandparents, 2 brothers and their wives, aunt and uncle all ended up staying for the weekend. There was a huge car show so the girls pretended to be interested for a few hours on Saturday morning. Then we split from the guys and headed to the mall for a good long while. After that we all met back up and headed to the beach to play for a while. There were hardly any waves and the tide was so far out you could walk on all the little sandbars close to the shore. K and I were kind of amazed we were still finding debris from Hurricane Katrina so long after it happened. He found a cool little piece of a 2x4 that was smoothed and rounded like sea glass. Sad :( Anyway, after our romp on the beach the 3 brothers and their wives went to a restaurant overlooking the ocean that we just knew would be awesome, but alas (frylime, that one's for you) that was not the case. However, the margaritas I made back at the condo later were quite tasty. The next morning we had to get up and leave, but we stopped at the outlet mall on the way home and shopped our little hearts out.
This post is getting terribly long, and I've got a killer case of acute sinusitis that reared it's ugly head today. (Thank you to Caden, my 2 year old niece who thought it was funny to wipe her boogers all over me this weekend) Those of you who know me well know how much that almost killed me...
Psych started today and I'm really happy with my partners and rotations. Wahoo!
Showing posts with label family medicine. Show all posts
Showing posts with label family medicine. Show all posts
Monday, October 12, 2009
Tuesday, April 14, 2009
Can't Wait
After our 2nd test of the day I'm going to go home, take a nice long nap, then wake up and take a nice long run (as long as the sun's still up). Hurry up and get here 1:30!!!
Tuesday, February 17, 2009
Hypotensive and Hypertensive?
So I was supposed to meet with my preceptor today to see patients, but he was in clinic for about 15 minutes so I went around with one of the residents. She's one of my favorites and has the best doctor-patient interaction skills I've ever seen.
In my 3.5 hours there we saw 6 patients. Two of them had the exact same name and were put in the exact same exam room, one right after the other. Weird. They couldn't have been more different though. One had never been on any medications and was 65. The other had more doctors, surgeries, and prescriptions than I could keep track of. She was nearly in shock when the doctor told her that a family medicine doctor could do more than just annual pelvic exams. "You mean, you can refill my prescriptions too?" Uh, yeah... Maybe not your morphine and hydrocodone, but we'll get to that later. I think when you're taking so many pain meds that you require daily phenergan or else you vomit all over the place it's time to reevaluate the situation. Whatever though. I don't know much. I'm just a student.
I got to hear 2 heart murmurs, though I really don't think I would have caught them if I hadn't known they were there. They were both very faint. I got to see otitis externa for the first time - that's just an infection of the ear canal and not an inner ear infection. Basically the canal looks red and inflamed with some flaky debris.
Probably the best part was when during a yearly check-up type thing for a new female adolescent patient the mom busts in during the doctor's history and starts asking questions about some online drug prescription plan thing that sounded kind of shady. Then the little girl busts in and says "Mom, this is MY time." Priceless. It was so true.
We also had an older patient who was STILL bitter about a breast lump from 5 years ago that wasn't picked up by radiology. She tried to tell us that calcifications in the breast tissue were a sign of cancer because they signified change. Umm no. You don't tell patients with calcification (a very normal thing that can happen in older women) to go out and get a double mastectomy. Whatever though. It's just kind of funny when the patient tries to tell you how to do your job. I'm not bitter though.
Oh yeah, I almost forgot the whole reason for the title. We had one patient who was hypertensive and obese (no diabetes Laura. She wasn't the trifecta :)) She was on no meds for hypertension. She had never been on any meds and was otherwise healthy. So the resident was going to start her on a drug for hypertension. Then she tells us sort of on the way out the door that she FAINTED last week. The way she described it was typical vasovagal syncope (fainting due to hypOtension). She got up from a seated position, walked to the bathroom, and woke up on the floor. This happens when blood pools in your veins when sitting or lying. You require the muscles of your legs working to pump the blood back up to the heart (and brain). Then she also mentioned some tingling sensations in her face and a feeling of something stuck in her throat. Seriously? Needless to say the doc decided not to go with the meds just yet and to get a further workup of the patient - EKG. The problem? No insurance. A simple in-clinic EKG is about $800 when you're self-pay. Some places don't care and just do all the tests, no matter how expensive or necessary. UMC tries to work with you and figure out what tests can be delayed, which are most important and the cheapest meds that are the most effective.
Anyway, that was just a typical day at the clinic. I kind of love family medicine so far, but I'm not sure that I won't fall in love with something else next year. I'll keep y'all updated.
In my 3.5 hours there we saw 6 patients. Two of them had the exact same name and were put in the exact same exam room, one right after the other. Weird. They couldn't have been more different though. One had never been on any medications and was 65. The other had more doctors, surgeries, and prescriptions than I could keep track of. She was nearly in shock when the doctor told her that a family medicine doctor could do more than just annual pelvic exams. "You mean, you can refill my prescriptions too?" Uh, yeah... Maybe not your morphine and hydrocodone, but we'll get to that later. I think when you're taking so many pain meds that you require daily phenergan or else you vomit all over the place it's time to reevaluate the situation. Whatever though. I don't know much. I'm just a student.
I got to hear 2 heart murmurs, though I really don't think I would have caught them if I hadn't known they were there. They were both very faint. I got to see otitis externa for the first time - that's just an infection of the ear canal and not an inner ear infection. Basically the canal looks red and inflamed with some flaky debris.
Probably the best part was when during a yearly check-up type thing for a new female adolescent patient the mom busts in during the doctor's history and starts asking questions about some online drug prescription plan thing that sounded kind of shady. Then the little girl busts in and says "Mom, this is MY time." Priceless. It was so true.
We also had an older patient who was STILL bitter about a breast lump from 5 years ago that wasn't picked up by radiology. She tried to tell us that calcifications in the breast tissue were a sign of cancer because they signified change. Umm no. You don't tell patients with calcification (a very normal thing that can happen in older women) to go out and get a double mastectomy. Whatever though. It's just kind of funny when the patient tries to tell you how to do your job. I'm not bitter though.
Oh yeah, I almost forgot the whole reason for the title. We had one patient who was hypertensive and obese (no diabetes Laura. She wasn't the trifecta :)) She was on no meds for hypertension. She had never been on any meds and was otherwise healthy. So the resident was going to start her on a drug for hypertension. Then she tells us sort of on the way out the door that she FAINTED last week. The way she described it was typical vasovagal syncope (fainting due to hypOtension). She got up from a seated position, walked to the bathroom, and woke up on the floor. This happens when blood pools in your veins when sitting or lying. You require the muscles of your legs working to pump the blood back up to the heart (and brain). Then she also mentioned some tingling sensations in her face and a feeling of something stuck in her throat. Seriously? Needless to say the doc decided not to go with the meds just yet and to get a further workup of the patient - EKG. The problem? No insurance. A simple in-clinic EKG is about $800 when you're self-pay. Some places don't care and just do all the tests, no matter how expensive or necessary. UMC tries to work with you and figure out what tests can be delayed, which are most important and the cheapest meds that are the most effective.
Anyway, that was just a typical day at the clinic. I kind of love family medicine so far, but I'm not sure that I won't fall in love with something else next year. I'll keep y'all updated.
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